By Sarah Fitzmaurice

Angelina Jolie has had a second operation, removing her ovaries and fallopian tubes, as a preventative measure against cancer.

The 39-year-old actress opened up about the operation writing a piece entitled Angelina Jolie Pitt: Diary of a Surgery in The New York Times.

'It is not easy to make these decisions,' she said. 'But it is possible to take control and tackle head-on any health issue.' In the article she explained about the procedure writing: 'It is a less complex surgery than the mastectomy, but its effects are more severe. It puts a woman into forced menopause.' Angelina will now take hormone replacements.

The mother of six revealed she had the operation (a laparoscopic bilateral salpingo-oophorectomy) a week ago - after being told that there were 'a number of inflammatory markers that are elevated, and taken together they could be a sign of early cancer.'

After this scare Angelina called her husband Brad Pitt - who flew back from France to LA to support her. She was tested and, thankfully, no tumour was dectected - but she decided to go ahead with the ovary removal.

She wrote: 'The day of the results came. The PET/CT scan looked clear, and the tumor test was negative. I was full of happiness, although the radioactive tracer meant I couldn’t hug my children. There was still a chance of early stage cancer, but that was minor compared with a full-blown tumor. To my relief, I still had the option of removing my ovaries and fallopian tubes and I chose to do it.'

In May 2013 Angelina revealed she had undergone a double mastectomy after learning that she carries the ‘faulty’ gene BRAC1. Angelina underwent genetic testing because her mother, Marcheline Bertrand, passed away when she was just 56, following a 10-year battle with ovarian cancer. Doctors predicted that Angelina had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer. Writing about the mastectomy operations in the New York Times Angelina said, ' I feel empowered that I made a strong choice that in no way diminishes my femininity.'

Speaking about her decision to have the second part of the surgery now she said: 'My doctors indicated I should have preventive surgery about a decade before the earliest onset of cancer in my female relatives. My mother's ovarian cancer was diagnosed when she was 49. I'm 39.'

Grazia spoke to Lester Barr, chairman of Genesis Breast Cancer Prevention, who explained why women tend to undergo this type of surgery before they are 40. ‘Women can get breast cancer in their 20s, 30s and 40s but the risk of ovarian cancer doesn’t really start until you’re 40,’ he said. ‘There aren’t really any good alternatives for preventing ovarian cancer so the decision can be a lot easier than with a mastectomy.’

Grazia Daily